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| Research article summary (published 30 Jul 2003): |
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Neuroprotection during cardiac surgery: a randomised trial of a platelet activating factor antagonist.
Full Abstract
OBJECTIVE:
To assess platelet activating factor (PAF) antagonists, potent neuroprotective agents in experimental cerebral dysfunction, in clinical practice.
DESIGN:
Double blind, minimised, placebo controlled trial of low and high dose PAF antagonist (lexipafant).
SETTING:
Cardiac surgery unit.
PATIENTS:
150 patients undergoing coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass.
INTERVENTIONS:
Randomisation to placebo, low dose (10 mg) or high dose (100 mg) lexipafant.
MAIN OUTCOME MEASURES:
Incidence of impairment on four established cognitive tests, undertaken before, five days, and three months after CABG, examined by three methods for defining impairment.
RESULTS:
The three groups were similar with respect to preoperative and intraoperative factors. Observed levels of cognitive impairment were less than had been predicted from previous studies. There was no difference in the groups in cognitive change scores at five days or three months. Group mean analysis showed significant time factors for all four tests but not for interactions or for the lexipafant group. A composite cognitive index, based on the aggregate of four normally distributed tests, showed a significant effect for timing of the test but not for the lexipafant group or interaction. Age, but not duration of bypass, was the most important determinant of postoperative cognitive impairment.
CONCLUSIONS:
The neuroprotective PAF antagonist lexipafant did not differentially reduce the level of cognitive impairment after CABG as determined by power estimates derived from published studies. The strongest predictors of cognitive impairment were age and timing of the test after operation.
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Author information
Author/s: Taggart, D P (DP); Browne, S M (SM); Wade, D T (DT); Halligan, P W (PW);
Affiliation: Department of Cardiac Surgery, John Radcliffe Hospital, Oxford, UK. david.taggart(-atsign-)orh.anglox.nhs.uk
Journal and publication information
Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Journal: Heart (British Cardiac Society) (Heart), published in England. (Language: eng)
Reference: 2003-Aug; vol 89 (issue 8) : pp 897-900
Dates: Created 2003/07/15; Completed 2003/09/02; Revised 2006/11/15;
PMID: 12860868, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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